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Comparison of umbilical cord serum and amniotic membrane transplantation in acute ocular chemical burns
  1. Namrata Sharma1,
  2. Shiv Shankar Lathi1,
  3. Sri Vatsa Sehra1,
  4. Tushar Agarwal1,
  5. Rajesh Sinha1,
  6. Jeewan S Titiyal1,
  7. Thirumurthy Velpandian1,
  8. Radhika Tandon1,
  9. Rasik B Vajpayee2,3
  1. 1Dr Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India
  2. 2Centre for Eye Research Australia, University of Melbourne, Melbourne, Victoria, Australia
  3. 3Royal Victorian Eye and Ear Hospital, Melbourne, Victoria, Australia
  1. Correspondence to Dr Namrata Sharma Cornea and Refractive Surgery Services, Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, Ansari Nagar, New Delhi-110026, India; namrata.sharma{at}gmail.com

Abstract

Purpose To compare the efficacy of umbilical cord serum (UCS) with amniotic membrane transplantation (AMT) in cases of acute ocular chemical burns.

Methods In a retrospective, interventional, comparative case series, 55 eyes with grades III, IV and V chemical burns (Dua's classification) who presented within 3 weeks of injury were evaluated. Patients were treated with conventional medical (CM group, 20 eyes) management alone or combined with either UCS (UCS group, 17 eyes) or AMT (AMT group, 18 eyes). The parameters evaluated were time to epithelialisation, epithelial defect diameter, epithelial defect area, corneal clarity, tear break-up time (TBUT), Schirmer test and best-corrected vision.

Results UCS and AMT groups showed early epithelialisation as compared with the CM group (Kaplan–Meier analysis=0.01). Mean time for healing of epithelial defect was 57.7±29.3, 27.4±19.0, 41.1±28.9 days in the CM, UCS and AMT groups, respectively (p=0.02). Mean TBUT at the last follow-up was 8.6±0.7, 10.3±1.1, 9.4±1.2 s in the CM, UCS and AMT groups, respectively (p=0.02). The mean Schirmer value at the last follow-up was 13.7±1.0, 16.9±3.0 and 13.2±1.5 mm in the CM, UCS and AMT groups, respectively (p=0.01). The visual outcomes and the occurrence of corneal vascularisation, symblepheron, ectropion and entropion were comparable in between the groups.

Conclusions Our study suggests that the UCS therapy may be a better alternative to AMT in acute moderate to severe (grades III, IV and V) ocular chemical burns, as it avoids surgical manoeuvre in already inflamed eyes.

  • Cornea
  • Treatment Medical
  • Treatment Surgery

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